diff --git a/backend/scripts/mdm_pass.py b/backend/scripts/mdm_pass.py
index 47cc380..6a8abfb 100644
--- a/backend/scripts/mdm_pass.py
+++ b/backend/scripts/mdm_pass.py
@@ -44,6 +44,44 @@ REQUIRED = MDM_SECTIONS[:3]
 
 MARKER = re.compile(r"\[\[(\d+)\|")
 NUMBER = re.compile(r"\d+(?:\.\d+)?")
+#: The "3." that opens an ordered-list item. It is a position in a list, not a
+#: fact, and it necessarily changes when a list is split across sections — so
+#: it is stripped before the numbers are compared. Requiring it to survive made
+#: the first pass keep the original numbering, which left sections opening on
+#: "2." and "4." because the list they came from had been divided.
+LIST_MARKER = re.compile(r"^(\s*)\d+([.)])(\s)", re.M)
+
+
+def facts_only(text: str) -> str:
+    """The text with ordered-list numbering removed, for comparing numbers."""
+    return LIST_MARKER.sub(r"\1\2\3", text)
+
+
+def renumber(text: str) -> str:
+    """Number every ordered-list item in this section from 1.
+
+    A list split across two sections leaves the second starting wherever the
+    first stopped — "2. Blood cultures" opening the Diagnosis section. Counting
+    is per indentation level, so a nested list is numbered independently of its
+    parent, and nothing else resets it: a blank line between items is a loose
+    list, not a new one, and prose in between does not restart the count.
+    """
+    counters: dict[int, int] = {}
+    out = []
+    for line in text.split("\n"):
+        match = re.match(r"^(\s*)(\d+)([.)])(\s.*)$", line)
+        if not match:
+            out.append(line)
+            continue
+        indent, _was, dot, rest = match.groups()
+        depth = len(indent)
+        for deeper in [level for level in counters if level > depth]:
+            del counters[deeper]
+        counters[depth] = counters.get(depth, 0) + 1
+        out.append(f"{indent}{counters[depth]}{dot}{rest}")
+    return "\n".join(out)
+
+
 MIN_RATIO, MAX_RATIO = 0.75, 1.35
 
 
@@ -94,7 +132,8 @@ def validate(before: list[dict], after: list[dict]) -> list[str]:
     if want != got:
         problems.append(f"cross-references changed (lost {sorted(set(want) - set(got)) or '-'}, "
                         f"added {sorted(set(got) - set(want)) or '-'})")
-    want_n, got_n = sorted(NUMBER.findall(old_text)), sorted(NUMBER.findall(new_text))
+    want_n = sorted(NUMBER.findall(facts_only(old_text)))
+    got_n = sorted(NUMBER.findall(facts_only(new_text)))
     if want_n != got_n:
         problems.append(f"numbers changed (lost {sorted(set(want_n) - set(got_n)) or '-'}, "
                         f"added {sorted(set(got_n) - set(want_n)) or '-'})")
@@ -172,7 +211,9 @@ def cmd_import(args) -> int:
                     "id": uuid.uuid4().hex,
                     "slug": slugify(section["title"]),
                     "title": section["title"],
-                    "content": section["content"],
+                    # Each section's lists start at 1, whatever they started at
+                    # in the block they were carved out of.
+                    "content": renumber(section["content"]),
                     "parent_id": None,
                     "variant": "clinical",
                 } for section in after]